Non-verbal IQ and change in restricted and repetitive behavior throughout childhood in autism: a longitudinal study using the Autism Diagnostic Interview-Revised.

BACKGROUND: Restricted and repetitive behavior (RRB) is one of the characteristic features of Autism Spectrum Disorder. This domain of symptoms includes a broad range of behaviors. There is a need to study each behavior individually to better understand the role of each in the development of autistic children. Moreover, there are currently no longitudinal studies investigating change in these behaviors over development. METHODS: The goal of the present study was to explore the association between age and non-verbal IQ (NVIQ) on 15 RRB symptoms included in the Autism Diagnostic Interview-Revised (ADI-R) over time. A total of 205 children with ASD were assessed using the ADI-R at time of diagnosis, at age 6 years, and at age 11 years, and with the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV) at age 8 years. RESULTS: The proportion of children showing each RRB tended to diminish with increasing age, except for sensitivity to noise and circumscribed interests, where the proportion increased over time. Although there was no significant main effect of NVIQ, there was a significant interaction between age and NVIQ. This was mainly driven by Difficulties with change in routine, for which higher NVIQ was associated with the behavior remaining relatively stable with age, while lower NVIQ was associated with the behavior becoming more prevalent with age. LIMITATIONS: The study focused on the presence/absence of each RRB but did not account for potential changes in frequency or severity of the behaviors over development. Furthermore, some limitations are inherent to the measures used. The ADI-R relies on parent report and hence has some level of subjectivity, while the Wechsler intelligence scales can underestimate the intellectual abilities of some autistic children. CONCLUSIONS: These results confirm that specific RRB are differentially linked to age and NVIQ. Studying RRB individually is a promising approach to better understanding how RRB change over the development of autistic children and are linked to other developmental domains.

Service utilization in a sample of preschool children with autism spectrum disorder: A Canadian snapshot.

OBJECTIVE: To describe services received by preschool children diagnosed with autism spectrum disorder (ASD) during the five-year period following their diagnosis. METHOD: An inception cohort of preschoolers diagnosed with ASD from Halifax (Nova Scotia), Montreal (Quebec), Hamilton (Ontario), Edmonton (Alberta) and Vancouver (British Columbia) were invited to participate. Parents/caregivers (n=414) described the services provided to their children at four time points: baseline (T1; within four months of diagnosis; mean age three years); six months later (T2); 12 months later (T3); and at school entry (T4). Data were first coded into 11 service types and subsequently combined into four broader categories (no services, behavioural, developmental and general) for analysis. RESULTS: More than 80% of children at T1, and almost 95% at T4 received some type of service, with a significant number receiving >1 type of service at each assessment point. At T1, the most common service was developmental (eg, speech-language therapy). Subsequently, the most common services were a combination of behavioural and developmental (eg, intensive therapy based on applied behaviour analysis and speech-language therapy). Service provision varied across provinces and over time. DISCUSSION: Although most preschool children with ASD residing in urban centres were able to access specialized services shortly after diagnosis, marked variation in services across provinces remains a concern.

OBJECTIF: Décrire les services qu'ont reçus des enfants d'âge préscolaire ayant un trouble du spectre autistique (TSA) pendant la période de cinq ans suivant leur diagnostic. MÉTHODOLOGIE: Une cohorte initiale d'enfants d'âge préscolaire ayant un TSA diagnostiqué et qui provenaient de Halifax (Nouvelle-Écosse), de Montréal (Québec), de Hamilton (Ontario), d'Edmonton (Alberta) ou de Vancouver (Colombie-Britannique) a été invitée à participer à l'étude. Les parents et les tuteurs (n=414) ont décrit les services fournis à leur enfant à quatre moments : au début (T1; dans les quatre mois suivant le diagnostic, âge moyen de trois ans); six mois plus tard (T2); 12 mois plus tard (T3) et à l'entrée à l'école (T4). Les chercheurs ont d'abord codé les données en 11 types de services, pour ensuite les regrouper en quatre catégories plus vastes (absence de services, comportementaux, développementaux et généraux) en vue de leur analyse. RÉSULTATS: Plus de 80 % des enfants ont reçu certains services à T1, et près de 95 % à T4, et un nombre significatif a reçu plus d'un type de services à chaque évaluation. À T1, le service le plus courant était de type développemental (p. ex., orthophonie). Par la suite, les services les plus courants étaient un mélange de services comportementaux et développementaux (p. ex., thérapie intensive selon l'analyse de comportement appliquée et orthophonie). La prestation des services variait selon les provinces et au fil du temps. EXPOSÉ: Même si la plupart des enfants d'âge préscolaire ayant un TSA qui habitaient dans un centre urbain avaient accès à des services spécialisés peu après le diagnostic, les variations marquées des services entre les provinces demeurent préoccupantes.

Language impairment and early social competence in preschoolers with autism spectrum disorders: a comparison of DSM-5 profiles.

Children with autism spectrum disorder (ASD) and structural language impairment (LI) may be at risk of more adverse social-developmental outcomes. We examined trajectories of early social competence (using the Vineland-II) in 330 children aged 2-4 years recently diagnosed with ASD, and compared 3 subgroups classified by: language impairment (ASD/LI); intellectual disability (ASD/ID) and ASD without LI or ID (ASD/alone). Children with ASD/LI were significantly more socially impaired at baseline than the ASD/alone subgroup, and less impaired than those with ASD/ID. Growth in social competence was significantly slower for the ASD/ID group. Many preschool-aged children with ASD/LI at time of diagnosis resembled "late talkers" who appeared to catch up linguistically. Children with ASD/ID were more severely impaired and continued to lag further behind.

Effects of high and low constraint utterances on the production of immediate and delayed echolalia in young children with autism.

This study examined the effects of adult antecedent utterances on the occurrence and use of echolalia in children with autism during a free play setting. Adult antecedent utterances were differentiated into two types, high and low constraint, based on the degree of linguistic constraint inherent in the adult utterance and social-communicative control exerted on the child's social and verbal interaction. Results of this study identified a variety of patterns of echolalia usage following adult high and low constraint utterances. Overall results found that a majority of immediate echoes followed high constraint utterances and were primarily used as responsives, organizational devices, and cognitives. The majority of delayed echoes followed low constraint utterances and were primarily used as requestives, assertives, and cognitives. Delayed echoes were more likely than immediate echoes to be produced with evidence of comprehension, but there were no differences in comprehension within the two categories of echolalia following high and low constraint utterances. Educational implications are discussed.

The effects of two levels of linguistic constraint on echolalia and generative language production in children with autism.

The effects of specific types of adult antecedent utterances (high vs. low constraint) on the verbal behaviors produced by three subjects with autism were examined. Adult utterance types were differentiated in terms of the amount of control the adults exhibited in their verbal interactions with the subjects during a free play setting. Videotaped interactions were analyzed and coded according to a predetermined categorical system. The results of this investigation suggest that the level of linguistic constraint exerted on the child interactants during naturalistic play sessions affected their communicative output. The overall findings suggest that (a) adult high constraint utterances elicited more verbal utterances in general, as well as a majority of the subjects' echolalia; (b) adult low constraint utterances elicited more subject high constraint utterances; and (c) the degree of constraint of adult utterances did not appear to influence the mean lengths of subjects' utterances. The results are discussed in terms of their implications for educational interventions, and suggestions are made for future research concerning the dynamics of echolalia in interactive contexts.

A comparison of symbol transparency in nonspeaking persons with intellectual disabilities.

This investigation compared the transparency of 11 different types of symbols representing objects with 40 nonspeaking subjects who experienced various degrees of intellectual disability. The subjects included a number of individuals with physical impairments or autism in addition to mild, moderate, or severe mental retardation. The symbol sets included: nonidentical objects, miniature objects, identical colored photographs, nonidentical colored photographs, black-and-white photographs, Picture Communication Symbols (PCS), Picsyms, Rebus, Self-Talk, Blissymbols, and written words. Statistical analyses indicated that real objects were more readily recognized than were any of the symbol sets and that Blissymbols and written words were more difficult than were any of the other sets. In addition, the results suggest the existence of a hierarchy of difficulty at the object (noun) level for the symbol sets assessed. The results are discussed in terms of their implications for selecting an initial symbol set for nonspeaking individuals. In addition, some suggestions for using the assessment protocols in clinical practice are presented, along with future research implications.

Synthetic and natural speech preferences of male and female listeners in four age groups.

The purpose of this investigation was to examine the preferences of listeners of both sexes in four age groups with regard to natural and computer-generated synthetic speech in six different contexts. The subjects (listeners) for this study included 5 males and 5 females in each of four age groups (6-8 year olds, 10-12 year olds, adolescents, and adults). The listeners rated their preferences for 11 different voices (four natural and seven synthetic) on a 5-point Likert scale. Their preferences were rated for six communication contexts dependent on the potential user of the voice (adult male, adult female, child male, child female, computer, and self). The data were analyzed separately for each of the six communication contexts. In general, female listeners across the age range indicated that only natural female voices (adult or child) were acceptable alternatives to their own speech, thus rejecting the natural male voices as well as the synthetic voices. Male listeners appeared to be somewhat more flexible in terms of gender-appropriateness for themselves and other adult men, but selected female-sounding voices for women and female children. Children preferred to have computers produce synthesized speech, while adults preferred computers with more natural-sounding voices. The results of this investigation raise a number of issues related to the combined effects of age and gender-appropriateness of natural and synthetic speech. These are discussed in terms of their implications for the future development of synthetic speech technology used in communication devices.

Gaze behavior: a new look at an old problem.

This article reviews the research and clinical literature that has investigated the topography and functions of eye-to-face gaze in normal children and adults. These data and data from a recent pilot study are then compared to the criteria typically used in eye-contact training programs with autistic children. This comparison reveals some educationally relevant discrepancies between the normative data and the training criteria. The need to base educational interventions for autistic individuals on normative standards is discussed, and suggestions for future research are provided.